Steatosis: Difference between revisions
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Non-alcoholic fatty liver disease1.jpg | ||
| Width = | | Width = | ||
| Caption = | | Caption = Steatosis. Elastic [[Masson's trichrome stain]]. | ||
| Synonyms = fatty liver | | Synonyms = fatty liver | ||
| Micro = fatty change (macrovesicular or microvesicular and periportal or centrilobular), negative for ballooning degeneration | | Micro = fatty change (macrovesicular or microvesicular and periportal or centrilobular), negative for ballooning degeneration, negative for significant inflammation - esp. [[neutrophils]] | ||
| Subtypes = macrovesicular steatosis (periportal, centrilobular), microvesicular steatosis | | Subtypes = macrovesicular steatosis (periportal, centrilobular), microvesicular steatosis | ||
| LMDDx = [[steatohepatitis]] (ASH, | | LMDDx = [[steatohepatitis]] (ASH, MASH), [[drug-induced liver injury]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
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| Molecular = | | Molecular = | ||
| IF = | | IF = | ||
| Gross = yellow, greasy, enlarged | | Gross = yellow colour, greasy/slippery feeling, enlarged | ||
| Grossing = | | Grossing = | ||
| Staging = | | Staging = | ||
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| Prevalence = very common | | Prevalence = very common | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = may be estimated by proton density fat fraction (PDFF) | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = dependent on underlying cause | | Prognosis = dependent on underlying cause | ||
| Other = | | Other = | ||
| ClinDDx = [[ASH]], [[ | | ClinDDx = [[ASH]], [[MASH]], [[drug-induced liver injury]] | ||
| Tx = dependent on underlying cause | | Tx = dependent on underlying cause | ||
}} | }} | ||
'''Steatosis''', also '''fatty liver''', is a fatty change in the liver associated with a number of underlying causes. | '''Steatosis''', also '''fatty liver''', is a fatty change in the [[liver]] associated with a number of underlying (medical) causes. | ||
==General== | ==General== | ||
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*Hepatitis D. | *Hepatitis D. | ||
*Weird stuff: | *Weird stuff: | ||
**Congenital defects of fatty acid beta oxidation | **Congenital defects of fatty acid beta oxidation. | ||
**Cholesterol ester storage disease | **Cholesterol ester storage disease. | ||
**Wolman disease and Alpers syndrome. | **Wolman disease and Alpers syndrome. | ||
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Centrilobular predominant (zone III) - ''DOA'':<ref name=pcddx_steatosis/> | Centrilobular predominant (zone III) - ''DOA'':<ref name=pcddx_steatosis/> | ||
*[[Diabetes mellitus]]. | *[[Diabetes mellitus]]. | ||
*Obesity, | *[[Obesity]], metabolic dysfunction-associated steatohepatitis ([[MASH]]). | ||
*Alcoholic liver disease, alcoholic steatohepatitis (ASH). | *[[Alcoholic liver disease]], alcoholic steatohepatitis (ASH). | ||
Periportal predominant (zone I) - ''TAPES'':<ref name=pcddx_steatosis/> | Periportal predominant (zone I) - ''TAPES'':<ref name=pcddx_steatosis/> | ||
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*Donor livers with more ''macrovescicular steatosis'' = worse outcome. | *Donor livers with more ''macrovescicular steatosis'' = worse outcome. | ||
**More than 30% means the liver is undesirable for [[Liver transplantation pathology|transplantation]].<ref>STC. 6 December 2010.</ref> | **More than 30% means the liver is undesirable for [[Liver transplantation pathology|transplantation]].<ref>STC. 6 December 2010.</ref> | ||
==Gross== | |||
*Yellow colour. | |||
*Greasy/slippery feeling. | |||
*Enlarged. | |||
Note: | |||
*May be estimated on MRI by proton density fat fraction (PDFF).<ref name=pmid23382291>{{Cite journal | last1 = Tang | first1 = A. | last2 = Tan | first2 = J. | last3 = Sun | first3 = M. | last4 = Hamilton | first4 = G. | last5 = Bydder | first5 = M. | last6 = Wolfson | first6 = T. | last7 = Gamst | first7 = AC. | last8 = Middleton | first8 = M. | last9 = Brunt | first9 = EM. | title = Nonalcoholic fatty liver disease: MR imaging of liver proton density fat fraction to assess hepatic steatosis. | journal = Radiology | volume = 267 | issue = 2 | pages = 422-31 | month = May | year = 2013 | doi = 10.1148/radiol.12120896 | PMID = 23382291 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
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<gallery> | <gallery> | ||
Image:Periportal_hepatosteatosis_intermed_mag.jpg | Periportal steatosis. (WC/Nephron) | Image:Periportal_hepatosteatosis_intermed_mag.jpg | Periportal steatosis. (WC/Nephron) | ||
Image:Non-alcoholic_fatty_liver_disease1.jpg | Centrilobular steatosis. (WC/Nephron) | Image:Non-alcoholic_fatty_liver_disease1.jpg | Centrilobular steatosis. (WC/Nephron) | ||
</gallery> | </gallery> | ||
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==See also== | ==See also== | ||
*[[Steatohepatitis]]. | *[[Steatohepatitis]]. | ||
*[[Medical liver disease]]. | |||
==References== | ==References== | ||